kate rathbun, md, mph concentra medical center 3235 perkins road baton rouge, la 70808 225-387-3030...
TRANSCRIPT
PRIMARY CARE IN DISASTERS
Winter storms HAZMAT Floods Fires Heat Emergencies Tornados Hurricanes Nuclear Power Terrorism Epidemics Earthquakes?
DISASTER
WHEN NEEDS EXCEED RESOURCES
Every Saturday night in the ER
24 / 7 / 365 for the Uninsured
Demographic War
KATRINA
1 million people evacuated 20% had chronic diseases 29th of August 250,000 in shelters River Center 25,000 people
80% turnover per day first aid only
PRIVATE RESPONSE
Ad Hoc clinics in shelters St James Church maternity program Dialysis – nephrology groups Ochsner opened the first day Baton Rouge Clinic on the 8th day All hospitals in Baton Rouge and
major hospitals in New Orleans stayed operational
GOVERNMENT RESPONSE
The federal government arrives in 3 days and leaves in 3 weeks
State government provides immediate response which ends after 3 to 6 weeks
Recovery requires 3 to 10 years
MYTHS
Local physicians are busy with their own problems
PMAC – 800 beds - the largest field hospital in history
National Guard to the rescue FEMA sent a lot of money USNS Comfort in Biloxi
REALITY
Local doctors got abuse and interference when they tried to respond
PMAC – 30 beds on the basketball court -120s beds in the field house
Governor’s orders, the National Guard blocked access to New Orleans
DH&H kept the money The Comfort saw 8 patients per day per
physician and were a thorn in the side of the Ocean Springs Hospital
PRIMARY CARE PREPARATION
As a medical society – demand a seat at the table at the county and state levels
Availability of primary care should be the main focus
Coordinate with other doctors to maintain continuity of care
Make sure your own practice is prepared
PREPARE AT HOME
Get a guide and follow it Prepare to leave in 30 minutes or
stay 7 days Make preparedness part of the
household routine Make arrangements with family and
friends before the event Communication is critical
PREPARE AT WORK
Phone tree & out-of-town contacts Emergency bags Flashlights, can openers, etc Business supplies for 2 weeks Lunches Weekly closing procedure
PREPARE THE BUSINESS
Good insurance Casualty, liability, business interruption
Computer billing records Off-site back-up
Alternative sites of practice Mutual aid agreements
PREPARE YOUR PATIENTS
Problem list & Medication list New copy at each visit
30 days of medications Where to go if you aren’t there Electronic medical records
Only for prearranged mutual aid
PREPARE THE MEDICAL COMMUNITY
THE GOAL IS RESILLIANCE
Mutual aid arrangements with shared records for OB, Oncology, Dialysis, etc.
Hospitals need urgent care centers away from the ER
Volunteer through the medical society not the health department
DURING THE DISASTER
Decide where and how you can be of the most value - go there and do that.
Decide when you will reopen your practice and what services you will provide
Know if you and your people will be paid
AFTER FEMA LEAVES
Plan so your practice stays viable Waves of leaving – What to avoid
can’t come back can’t rebuild can’t face the next 10 years
Remember, you only get your insurance payment once